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Role Description

You will support the design, optimization, and implementation of processes and improvements to operations in support of achieving organizational goals. You will be responsible to support implementations for regulatory requirements, compliance initiatives, UM audits, and other projects, as needed.

You will report into the Senior Manager, UM Regulatory Operations.

Work Location:

• This is a remote position, open to candidates who reside in: Dallas, Texas.
• You will be fully remote; however, our approach to work may adapt over time.
• Future models could potentially involve a hybrid presence at the hub office associated with your metro area.

Pay Transparency:

• The base pay for this role is: $67,813 - $89,004 per year.
• You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

Responsibilities

• Coordinate projects and processes to help support key regulatory and compliance milestones and deliverables
• Partner with leadership to implement regulations, support key state filings, and other projects
• Partner with cross-functional teams to ensure action plans and process improvements align with project goals, and participate in collaboration with peers and cross-functional stakeholders
• Support audit exams (NCQA, MHPAEA, State)
• Help identify risks; respond to and resolve compliance gaps through regulatory implementation and in response to audits and Corrective Action Plans
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements

• 1+ years of professional experience in utilization management, healthcare operations and/or compliance, or a related field
• 1+ years of experience in Adobe Acrobat, and Google Suite or Microsoft Office (Sheets/Excel, Docs/Word, Slides/Powerpoint, etc)
• 1+ years of experience in process improvement, healthcare policy implementation
• 1+ years of experience with interdepartmental collaboration with stakeholders to drive projects

Bonus points

• 1+ years of experience supporting state audits and exams
• ACA marketplace, utilization management, healthcare quality and compliance, or provider data experience
• Training or experience applying Continuous Process Improvement or Lean Six Sigma principles
• Experience with project coordination or management in a matrixed organization
• 1+ years of experience in developing and presenting information and recommendations

Benefits

• Full-time employees are eligible for benefits including: medical, dental, and vision benefits
• 11 paid holidays
• Paid sick time
• Paid parental leave
• 401(k) plan participation
• Life and disability insurance
• Paid wellness time and reimbursements